title: HIV and hepatitis C virus testing delays at methadone clinics in Guangdong Province, China.
abstract: In China, injection drug use is a major transmission route for HIV and hepatitis C virus (HCV) infection. Timely HIV and HCV testing among drug users is vital to earlier diagnosis, linkage to care, and retention. This study aimed to examine HIV and hepatitis C virus (HCV) testing delays at methadone clinics in Guangdong Province, China, and identify individual-level and clinic-level factors associated with delayed testing. Data from 13,270 individuals at 45 methadone clinics in Guangdong were abstracted from a national web-based surveillance database. A two-level binomial logit model was used to examine the association between individual- and clinic-level factors and delayed HIV and HCV testing, defined as receiving a test seven or more days after initial entry into the methadone system. Among 10,046 patients tested for HIV, 1882 (18.7%) had delayed testing; among 10,404 patients tested for HCV, 1542 (14.8%) had delayed testing. Among delayed testers, the median time to HCV testing was significantly longer than the median time to HIV testing (73 vs. 54 days, p<0.05). In the multivariate analysis, the likelihood of delayed HIV testing was higher among individuals with high school or greater education (adjusted odds ratio [aOR] 1.32, 95% confidence interval [CI] 1.02-1.72) and individuals enrolled at clinics with more patients (aOR 1.41, 95% CI 1.05-1.91, for each increase in 100). The likelihood of delayed HCV testing was higher among women (aOR 1.51, 95% CI 1.11-2.06) and employed individuals (aOR 1.21, 95% CI 1.02-1.43). Delayed testing for HIV and HCV is common among patients at methadone clinics in Guangdong, with many patients experiencing delays of two or more months. Structural interventions are needed to expedite testing once individuals enter the methadone maintenance program.
authors.affiliation: Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, PR China.
authors.forename: Ying-Hua
authors.initials: YH
authors.lastname: Xia
authors.forename: Megan M
authors.initials: MM
authors.lastname: McLaughlin
authors.forename: Wen
authors.initials: W
authors.lastname: Chen
authors.forename: Li
authors.initials: L
authors.lastname: Ling
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Tucker
mesh_terms: D000328:Adult; D044466:Asian People; D002681:China; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000208:ethnology / Q000821:virology; D006526:Hepatitis C / Q000175:diagnosis* / Q000208:ethnology / Q000821:virology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D015999:Multivariate Analysis; D058850:Opiate Substitution Treatment / Q000379:methods; D011159:Population Surveillance / Q000379:methods; D012959:Socioeconomic Factors; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data*; D013997:Time Factors; D055815:Young Adult
chemical_list: D008691:Methadone